Organization
EXECUTIVE PHYSICAL THERAPY PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. MARTHA CECULIA ANIBAL PT (PHYSICAL THERAPY ADMINISTRATOR)
(718) 426-1515
Entity
Organization
Contact information
Practice address
7802 ROOSEVELT AVE STE 212, JACKSON HEIGHTS, NY 11372-6626
(718) 426-1515
(718) 426-0133
Mailing address
7802 ROOSEVELT AVE STE 212, JACKSON HEIGHTS, NY 11372-6626
(718) 426-1515
(718) 426-0133
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
02/22/2013
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